I N S I DE

TH I S I S SUE :

Mortality 2

Infant

Mortality

3

Morbidity in

Montgomery

3

Emerging

Health Issues

4

Teen

Pregnancy

5

Obesity 6-9

Physical

Activity

10-12

New Economic

Initiative

12

D E C E M B E R 2 0 1 0 V O L U M E 1 , I S S U E 1

Demographics Montgomery

County

North

Carolina

*Population, 2009 estimate 27,745 9,380,884

*Ethnicity (2009) White Persons, Not Hispanic: Black Persons: Hispanic or Latino Persons: Asian Persons: Other:

61.4% 19.4% 16.5% 2.0% 0.7%

66.8% 21.6% 7.7% 2.0% 1.9%

*Median Household Income (2008)

$37,180 $46,574

*Per Capita Income, 1999 $16,504 $20,307

*Persons Below Poverty, 2008

19.6% 14.6%

**Unemployment Rate–(September 2010) (March 2010)

12.2% 14.1%

9.6% 11.1%

Percent of Children:

***In Poverty

(2007) (2008)

23.7% 28.3%

19.5% 19.9%

***Without Health Insurance (2007)

19.9% 13.1%

***Enrolled in Free and Reduced Lunch (2007)

79.1% 54.8%

*Source: US Census Bureau **Source: www.ncesc.com ***Source: www.ncchild.org

Submitted by the Health Education

Staff of the Montgomery County Health Department 217 South Main St.

Troy, NC 27371 (910) 572-1393

Montgomery County At A Glance

Montgomery County Priority Areas

In 2008, representatives from many agencies and organizations

in the county collaborated to complete a Community Health Assessment. This multi-phase project included collection and analysis of data gathered from

community opinion as well as state and local sources. Once this information was gathered, a

community forum was held, and the following three areas were

chosen as priority health issues for Montgomery County: (1)Teen

Pregnancy (2) Obesity and (3) Physical Activity and Recreation

Opportunities. Although the county does not have a

certified Healthy Carolinians organization in place, a

collaborative group initiated by FirstHealth of the Carolinas is in

place and meets regularly. Members of this committee are

listed on page 12 of this publication. This group, called the

Montgomery 2020 Vision Committee, partnered in June

2009 to develop action plans to address these key areas. These

plans can be viewed by visiting the Montgomery County website.

Progress toward these goals is highlighted in this report, along with a review of mortality and

morbidity data and other emerging health issues.

STATE OF THE COUNTY HEALTH REPORT

MONTGOMERY COUNTY

P A G E 2

“Cancer and heart

disease have

consistently

ranked highest in

their toll on the

people of North

Carolina” State

Health Director

Jeff Engel said.

“For the most

part, these are

preventable

diseases, so we

must continue to

educate our

citizens about

lifestyle changes

they can make to

stay healthier.”

Mortality in Montgomery S

ource: North C

arolina State C

enter for Health S

tatistics

The N.C. Division of Public Health reports

that cancer is now the leading cause of

death in North Carolina and

Montgomery County. According to newly

released 2009 statistics, cancer

claimed the lives of 62 people in

Montgomery County during 2009. Heart

disease was responsible for 49

deaths in the county.

North Carolina and Montgomery County

share the top two leading causes of

death, but Cerebrovascular

disease is 3rd for the state, followed by

chronic lower respiratory disease, and unintentional injuries. Chronic

Lower Respiratory Disease is the third

leading cause of death for the county,

followed by Cerebrovascular

disease and Alzheimer’s disease.

2009 North Carolina Leading Causes of Death

Montgomery County

North Carolina

Total Deaths 889.8 820.1

Cancer 221.6 186.3

Heart Disease 175.1 182.6

Chronic Lower Respiratory Disease 60.8 46.1

Cerebrovascular Disease 50.0 46.8

Alzheimer’s Disease 42.9 28.2

All Other Unintentional Injuries 39.3 29.5

Diabetes Mellitus 28.6 22.5

Unintentional Motor Injuries 28.6 14.9

Kidney Disease 17.9 19.5

Suicide 17.9 12.4

Septicemia 14.3 14.0

Homicide 14.3 6.0

Pneumonia/Influenza 10.7 18.3

Chronic Liver Disease 3.6 9.9

HIV Disease 0.0 3.8

Rank 00-19 Years 20-39 Years 40-64 Years 65+ Years

1 Perinatal Conditions Motor Vehicle Injuries Cancer Heart Disease

2 Motor Vehicle Injuries Unintentional Injuries Heart Disease Cancer

3 Birth Defects Homicide Unintentional Injuries Chronic Lower Respiratory Disease

4 Unintentional Injuries SIDS

Cancer Chronic Lower Respiratory Disease

Cerebrovascular Disease

5 Heart Disease/ Chronic Lower Respiratory

Disease/Suicide

HIV Heart Disease

Diabetes Suicide

Alzheimer’s Disease

2005-2009 Leading Causes of Death by Age Group Source: North Carolina State Center for Health Statistics

The table above reveals that heart disease is a leading cause of death for all age groups in Montgomery County.

P A G E 3

The N.C. Healthy Start

Foundation explains “that infant

mortality is the death of a baby

before it’s first year of life. Infant

mortality rates are the number of infant deaths for every 1,000 live births

within a given time frame (usually a year). Infant mortality is thought to be a

social problem with medical consequences and is often considered a measure

of the general health of a community”. In 2009, North Carolina’s infant

mortality rate was the lowest in the state’s history. 7.9 babies died in 2009

for every 1,000 born alive. This is down from 3.7% from 2008 (8.2

death/1,000 live births) and 37 percent since 1988 when North Carolina had

the highest infant mortality rate in the nation. Montgomery County rates

mimic the state trend and have dropped to 6.3, which is lower than the state

rate. The N.C. Healthy Start Foundation also reports the three major

causes of infant death to be prematurity and low birth weight, birth defects

and Sudden Infant Death Syndrome (SIDS). Of increasing concern is the

difference in death rates between babies of different races and ethnicities.

In Montgomery County the white fetal death rate is only 4.1, as compared to

the minority fetal death rate of 13.0. The Montgomery County Health

Department continues to provide the “BabyLove” care coordination

program. Through this initiative, a nurse recruits pregnant women to

participate, and then follows them through their pregnancies ensuring the

women are obtaining health care and assisting them with a variety of

pregnancy-related issues. The free program is available to all pregnant

women, and Spanish interpreters are available to assist the Hispanic

population. The Montgomery County Health Department employs two

BabyLove maternity care coordinators, and averages a monthly total

caseload of about 75 women, roughly 33% of which are black, and 33% are

Hispanic.

Additionally, five

local

organizations

(Montgomery

County

Partnership for

Children,

Montgomery

County

Cooperative

Extension

Service,

Montgomery

County Health Department, FirstHealth of the Carolinas, and Stanly Regional

Medical Center) partner annually to host a pregnancy fair to link pregnant

women with a variety of local resources.

Morbidity refers to the relative incidence of a

particular disease or illness in a given area.

The table above shows that Montgomery County

rates are lower than the state rates for all types

of communicable disease with the exception of

tuberculosis (TB). Even though TB rates

continue to be higher for the county, rates for

the past three years have dropped. The total

cancer incidence for the county is 436.8, and is

lower than the total cancer incidence rate for the

state which is 484.7. Montgomery County

creeps above state rates only in the area of lung/

bronchus cancer rates. Hospital utilization

reports, which can be accessed at the North

Carolina State Center for Health Statistics

website indicate the top three leading causes of

hospital admissions for Montgomery County

residents are cardiovascular and circulatory

diseases, respiratory diseases, and digestive

system diseases.

Risk Factors (2004-2008): Montgomery North Carolina

Births to Mothers Who Smoked Prenatally

13.0% 11.5%

% of Women Receiving Prenatal Care in the First Trimester

76.1% 82.1%

% of Short Intervals Between Births

11.2% 12.7%

Mothers Under 30 with High Parity

21.6% 18.0%

Mothers Over 30 with High Parity 26.1% 20.0%

Sou

rce:

Nor

th C

arol

ina

Sta

te C

ente

r fo

r H

ealth

Sta

tistic

s Mont. NC

AIDS Rates (2003-2007)

9.5 12.0

Gonorrhea Rates (2009)

76.8 160.6

Primary and Secondary Syphilis Rates (2004-2008)

0.7

3.1

Tuberculosis Rates 2005 2006 2007 2008 2009

40.2 59.6 14.1 10.7 3.5

3.8 4.6 3.8 3.6 2.7

Chlamydia Rates (2009)

233.9 474.2

2007 Hospital Discharges with Primary Diagnosis of ASTHMA

• All Ages • 0-14 years

65.1 87.7

115.4 151.9

Infant Mortality Rates Drop Morbidity Rates

in Montgomery Lower than State Rates

Source: North Carolina State Center for Health Statistics

P A G E 4

Emerging Health Issues Montgomery Free Care Clinic

Now Open. Access to care is always an issue in Montgomery County due to several factors which include but are not limited to lack of providers, transportation issues and high rates of uninsured individuals. To further complicate these issues, in 2010, a primary care provider office in Star closed the practice. A group of concerned citizens and organizations worked together in 2010 to leverage funding to establish a Free Care Clinic in Montgomery County. The steering committee included representatives from a local bank, an attorney’s office, the Town of Biscoe, local health care providers, FirstHealth Montgomery Memorial Hospital, faith communities and community leaders. The steering committee worked collaboratively under the leadership of the Executive Director, Breon Allen, to establish policies and procedures, and recruit volunteers in order to open the clinic. On September 28, 2010, the Montgomery Free Care Clinic, which is located in Biscoe, officially opened to treat patients. The clinic functions through volunteerism from providers, nurses and community members. The clinic is open on Tuesday nights for approximately eight patient visits per week. To date, the clinic has seen individuals with chronic disease conditions as well as individuals in need of acute care. Montgomery County Free Care Clinic has assisted unmanaged hypertensive individuals with blood pressures as high as 220/180, uncontrolled asthma patients, and uncontrolled diabetic patients with glucose readings over 300 and HbA1c of 14 (normal is 6). The clinic Board of Directors continues to actively seek additional funds to expand clinic hours and to obtain paid provider staff, which will guarantee additional clinic hours. For more information on the Montgomery Free Care Clinic, please

contact Breon Allen, Executive Director by emailing allen@ac.net or calling (910) 428-9020.

Food Safety Education. Food safety education is essential to the prevention of food borne illness in the United States. According to the Centers for Disease Control, an estimatd 76 million illnesses, 322,914 hospitalizations, and 5,194 deaths are attributed to food borne illness in the United States each year. Consumers view the Cooperative Extension Service as the experts in food safety information. As more people look at growing and preserving their own food, the Montgomery County Cooperative Extension Service has been working to offer more classes to help them practice safe growing, harvesting, and preserving of the food they grow. The Family Consumer Science Agent in Montgomery County has worked to provide a series of classes including Basic Food Safety; Canning and Freezing Basics; and What to do with all these Tomatoes. The agent has also written a newspaper arti-cle on the importance of getting your Pressure Canner tested each year and offers this as a free service to the community during canning season. This year Montgomery County Cooperative Extension has tested 22 pressure canners with the dial type gauges. The average cost of one case of food borne illness is $612. This free service could potentially result in a savings of a minimum of $13, 464 due to the prevention of food borne illness cases. For more information on Food Safety, contact Molly Alexi, Montgomery County Cooperative Extension Service Director by calling 910-576-6011 or emailing her

at molly_alexi@ncsu.edu.

More Chlamydia Cases in 2010 than 2009. While the Chlamydia cases for the state have consistently increased from 2008-2010, the number of cases in Montgomery County have been less stable. From January through September in 2008, Montgomery had 69 confirmed cases. That number dropped in 2009 to just 52, but rose dramatically back to 73 confirmed cases in 2010 for the same time period. North Carolina case numbers are 28,313 for 2008; 32,982 for 2009, and 34,088 for 2010. For more information on Chlamydia, STDs or other Communicable Diseases in Montgomery County, contact Mary Perez at the Montgomery County Health Department at (910) 572-1393x293 or

emailing mary.perez@montgomerycountync.com.

Montgomery

Smiles Again!

In September 2010, Montgomery County Schools collaborated with various local dentists to implement the Montgomery Smiles Again! project. The purpose of the project is to increase the number of children in Montgomery County who receive dental care. Participating children have the opportunity to ride the bus to a local dental office to receive preventive care such as a cleaning, exam, fluoride, and sealants. If the child has decay, the dentist will provide that treatment as well.

If you have questions or would like more

information about the Montgomery Smiles

Again program, please contact

Larry Jenkins at the Montgomery County

Schools Administration Office

at 910-576-1742.

Montgomery Free Care Clinic in Biscoe

P A G E 5

Priority Issue: Teen Pregnancy

Source: Adolescent Pregnancy Prevention Campaign of North Carolina **Rates based on fewer than 20 cases are statistically unreliable and are not presented.

Mont. Cty.

NC

Adolescent pregnancies among 10-14 year olds

1 324

Rate per 1,000 girls aged 10-14 years old

** 1.1

Adolescent pregnancies among 15-19 years old

58 18,142

Rate per 1,000 girls aged 15-19 years old

62.5 56.1

NC county ranking (1st highest-100th lowest)

38 —

% of pregnancies that were repeat pregnancies

25.9 28.6

MONTGOMERY COUNTY at a Glance

2009 Mont.

Cty. NC

Adolescent pregnancies among 10-14 year olds

0 376

Rate per 1,000 girls aged 10-14 years old

0 1.3

Adolescent pregnancies among 15-19 years old

68 19,398

Rate per 1,000 girls aged 15-19 years old

76.8 58.6

NC county ranking (1st highest-100th lowest)

19 —

% of pregnancies that were repeat pregnancies

36.8 28.4

2008

Experts credit the increased use of targeted evidence-based teen pregnancy prevention programs as one cause of the improvement in pregnancy rates. The Montgomery County Health Department used funds from the Kate B. Reynolds Charitable Trust to implement the Teen Outreach Program beginning in 2007. At the conclusion of that grant cycle, the department applied for and received $260,000 in funding from the N.C. Division of Public Health’s Teen Pregnancy Prevention Initiative (TPPI) to continue the program in both high schools in

the county for four more years. Additionally, the health department will expand the program by implementing it in Camp E-Ku-Summee beginning in January 2011. To date, 19 classes have been conducted between East and West High School, with a total of 362 students participating and graduating from TOP. All outcome goals and objectives were met and often exceeded each year. These objectives included measuring lifestyle changes, knowledge of risky behaviors, goal setting and community awareness. Out of the 362 students, it is estimated that 4 of the females became pregnant, 10 students left the school because they moved or were pursuing a GED, and one dropped out of school due to a pregnancy. It is important to note that at least 2 of the 4 girls were already pregnant at the time TOP classes started. A three year summary prior to implementation of the TOP program indicates: 30% of students reported already being sexually active; 20% reported having been suspended from school; 12% reported having used illegal drugs; 30% reported having used alcohol; 30% reported having ever participated in community service. A Teen Advisory Council has been established which is made up of students from both high schools that have graduated from the TOP program. The Teen Advisory Council helps to plan outreach and education activities. An adult TOP Community Advisory Council has been in place since the beginning of the TOP program, and in September 2010, the group formally expanded to serve as the lead task force for addressing teen pregnancy in Montgomery County, and is now called Montgomery County Teen Pregnancy Prevention Community Advisory Council. The council will continue to oversee the TOP program but will also seek out other strategies to address the issue that will have a larger target population. For more information on how to become involved with the council, please contact Cathy Kennedy, TOP Program Manager by calling her at the Montgomery County Health Department at (910) 572-1393 or emailing cathy.kennedy@montgomerycountync.com.

0

20

40

60

80

100

2005 2006 2007 2008 2009

Teen Pregnany Rates, 2005-2009

Montgomery

North Carolina

Teen Pregnancy was identified as a health priority for the county during the Community Health Assessment process in 2008. In 2009, action plans were adopted to address the issue between 2008 and 2012. Included in the plan were (1) marketing and educational outreach activities directed at parents, students and community members, (2) the establishment of a Teen Pregnancy Prevention Council of Montgomery County comprised of participants from at least three county organizations and agencies, and (3) the continued implementation of the Teen Outreach Program. To date, the council has been established and the TOP program is still moving forward. State and local data show that we are moving in the right direction, as tremendous drops in teen pregnancy rates and repeat teen pregnancy rates have been demonstrated. Although these successes should be celebrated, it is important to note that the problem is far from being solved. Even with these improvements, North Carolina still has the 14th highest pregnancy rate in the nation.

P A G E 6

Priority Issue: Child and Adult Obesity Childhood and adult

obesity was also chosen as a

community health priority for the years

2008-2012 in Montgomery County.

The action plan to address this issue

includes (1) Market-ing Activities in a variety of settings targeting a variety

of audiences, (2) Implementation of

the Nutrition and Physical Activity Self-Assessment for Child

Care Centers (NAP-SACC Project), (3) Implementation of

the Healthy Living Every Day (HEED)

classes, (4) Ongoing Educational and

Outreach Activities, and (5) Body Mass

Index Measurements for Students. Data

shown in the following pages will show that

obesity rates continue to be a problem for

both adults and children in the county, but that tremendous

work is being done to meet the goals outlined in the action plan.

Childhood obesity is currently at epidemic proportions in the US with 30% of children ages 2-19 being overweight or obese (Ogden et al., 2010). For adolescents, the percentage of overweight/ obesity is 30.6% nationally, with North Carolina adolescents slightly higher at 33.9% (Childhood Obesity Action Network, State Obesity Profiles, 2008). Unfortunately for Montgomery County, currently 48% of our adolescents are overweight or obese, much higher than the state and national averages. According to the CDC, 2010, the consequences of childhood

obesity are numerous, with increased risk of serious early-onset adult diseases such as diabetes, hypertension and elevated cholesterol levels that contribute to heart disease, and other serious diseases such as asthma, sleep apnea, fatty liver disease and orthopedic issues. In addition, psychological implications include stigmatization and low self-esteem (CDC, 2010), and increased risk for anxiety, depression and suicidality (Swahn et al, Journal of Adolescent Health, 2009). The FirstHealth Montgomery County School Health Centers (SHCs) have collaborated with Montgomery County Schools for three consecutive years to collect BMI data on all students in the system. These data have been compiled for the past three school years and have provided the impetus for developing strategies to address the childhood obesity epidemic that is rampant in Montgomery County. The FirstHealth Montgomery School Health Centers have developed targeted program such as HEAP “Healthy Eating Active Play” for specific grades with high percentages of overweight and obese students. Additionally, as a result of the 2020 committee collaboration, an after school program was developed for West Middle School last school year that included nutrition education, physical activity and End of Course test preparation and was felt to be very successful. Tremendous work is being done throughout the county to address the obesity issue for adults and children (more information can be found in the upcoming pages of this report). Although the overweight/obesity rate among Montgomery County students currently remains high, overall at 47%, we are beginning to see some positive trends. During the 2009-2010 school year, there was a 4% decrease in obesity at West Middle School, with both East and West Montgomery High Schools decreasing their obesity percentages by 2%. For students

at the SHCs who received 2 or more nutritional counseling visits, during the 2009-2010 school year, 90% of the students decreased their BMI at East Middle School, and 86% of the students at West Middle School decreased their BMI, with similar results for the 2008-2009 school year. There is still much work to be done, but with a continued collaborative approach, it is felt that we will continue to see positive results with the ultimate goal of decreasing the number of overweight and obese students in Montgomery County. Adult Data. According to the 2009 Behavioral Risk Factor Surveillance System, almost 64% of respondents in the Piedmont region (of which Montgomery County is a part) responded that they have a body mass index that is greater than 25, which is classified as overweight or obese. Further breakdown shows that 77% of males, 57% of females, 61% of white respondents, 75% of African American respondents, and 72% of Hispanic respondents all indicate being overweight or obese according to their BMIs. Therefore, it is imperative that the work in our county focuses on decreasing obesity rates in both children and adults– and activities that can overlap and reach both

target groups at once are also favorable.

For more information about childhood obesity, or the BMI studies, please contact Regina Smith, MSN, FNP-C, by calling her at either 910-428-9392, 910-572-1979 or emailing RPSmith@firsthealth.org.

For more information on obesity statistics, visit www.eatsmartmovemorenc.com.

Montgomery County Schools BMI Data 2009-10

28%

19%

51%

2%

BMI ≥ 95%

BMI 85%-94%

BMI Normal

BMI < 5%

Montgomery County Schools 3-Year Comparative Data

0

500

1000

1500

2000

2500

BMI ≥ 95% BMI 85-94% BMI Normal BMI < 5%

Num

ber

of S

tuden

ts

2007-08

2008-09

2009-10

Montgomery County Adolescent BMI Comparison

0

10

20

30

40

50

60

2008 2009 2010

Per

cen

tag

e o

r O

verw

eig

ht/

Ob

ese

Montgomery CountySchoolsNorth Carolina

United States

(US/NC Data - Childhood Obesity Action Network, State Obesity Profiles, 2008)

New Obesity Initiatives Include:

• People Living Active Year-Round (PLAY)

• Film Screenings

• Food Safety and Nutrition Education program

• Tailgate Markets

• Classroom Celebration

P A G E 7

Healthy Eating Every Day…..The Happy Kitchen

Outreach and Education about Obesity

Healthy Eating Every Day (HEED) is a 12-week program consisting of one hour weekly sessions. Class content focuses on assisting individuals in developing the skills for diet-specific behavior change using evidence based curriculum. Food models, taste tests, cooking demonstrations, HEED Bingo, field trips to local grocery stores and promotion of local Farmer’s Markets and recipes supplement class materi-als. After serving 24 participants in one class, HEED phased out this year due to the popularity and success of The Happy Kitchen program. The Happy Kitchen/La Cocina Alegre TM teaches participants to prepare tasty, healthy and inexpensive meals that provide good nutrition for participants and their families. The 90 minute weekly sessions use the USDA food pyramid and focus on a different food group each week. In each class, a recipe is prepared using seasonal, minimally processed, whole foods and participants are provided the recipe ingredients to take home and prepare with their family. Along with the meal preparation in class, nutrition education is provided each week. Recipe ingredi-ents are purchased through local farmers markets and farm co-ops/ Community Supported Agricul-ture (CSA). Participants learn how to buy and prepare fresh local foods. Additionally, the translated materials have allowed Healthy Living in the Mid-Carolinas to conduct classes in Spanish. Eight Happy Kitchen classes, with a total of 86 participants have been conducted in Montgomery County in 2010. For more information about Healthy Living Every Day, or the Happy Kitchen, please contact Linda

Harte, with FirstHealth of the Carolinas by calling (910) 255-3643, or emailing lharte@firsthealth.org.

Active Living Every Day…..People Living Active Year-Round

Active Living Every Day (ALED) is a 12-week program consisting of one-hour weekly sessions, focused on developing the skills to increase physical activity. An evidence-based curriculum is utilized, and class work is supplemented with Eat Smart, Move More NC materials. Field trips to local walking trails, parks and gardens are also included in the program. One ALED class with 26 participants was conducted this year. The ALED Program is being phased out due to the success of a pilot program called “PLAY”- People Living Active Year-Round. Due to the popularity and improved retention and improvement rates with the newly added Happy Kitchen class and its format, a 6-week, interactive physical activity program called PLAY was developed and pilot tested. The 6-week format incorporates not only the behavior change model, but also has an interactive component where participants are actively engaged each session with a 10-15 minute activity. Activities were chosen to reflect the 2008 Physical Activity Guidelines for Americans issued by the Department of Health and Human Services. Two PLAY classes have been conducted with a total of 43 participants in Montgomery County in 2010. For more information about Active Living Every Day, or PLAY, please contact Linda Harte, with FirstHealth of the Carolinas by calling (910) 255-3643, or emailing

lharte@firsthealth.org.

“I used the food dietary sheets

and started writing down all

the foods I ate. I now eat more fresh fruits and

vegetables, whole grains,

frozen fruits and veggies, and wash canned

veggies. I have lost 8 pounds!”

~Happy Kitchen Participant

“I have a more positive attitude

toward exercising

every day.”

“I have become more aware of

idle time and now try to get at least 10,000 steps per day.”

~PLAY participants

Sites include:

Green Ridge Elementary School, First Wesleyan Church, Monarch, Gilbralter, Cooperative Extension, Wesleyan Homes, Senior Center, Montgomery Community College, and Candor United Methodist Church.

P A G E 8

of fruits and vegetables, while decreasing their consumption of unhealthy foods and decreasing portion sizes to the proper levels. Food and Activity Journals, Meal P la nners , Wipe- Off Boa rd s , motivational magazines, and other learning materials were distributed through the series. Other than the documented hea lth benef its, part ic ipant eva luat ion forms reflected enjoyment of the class and the group support offered through the program. One member stated, “I really enjoyed the program. I learned a lot about changing our eating habits and calorie content. It helped my husband also– he lost

Eat Smart, Move

More, Weigh Less. A series of weekly classes designed to help participants achieve and maintain a healthy weight through lifestyle changes, was offered to Montgomery County Employees during the Spring of 2010. Ending on April 28th, six employees and the instructor lost a collective total of just over fifty pounds, and many lost inches and saw decreases in blood pressure. Almost all participants reported leading a more active lifestyle and increasing their consumption

more weight than I did! “ A class reunion was held in June, and all participants reported maintaining their weight, and some have continued to lose weight. Offered through the cooperation of the Montgomery County Employee Wellness Committee and the Montgomery County Health Department, the series will be offered again if there is enough employee interest. The program is also available to other businesses, organizations or groups in the county by contacting Rhonda Peters at the Health Department: rhonda.peters@montgomerycount

ync.com.

Outreach and Education about Obesity

Marketing Activities

Various 2020 Vision

Committee members have promoted the

7 Key Messages of Eat Smart, Move More

North Carolina in a variety of venues. An

informational display board was created at

the Health Department and

committee members used it in community

events and health fairs

throughout the county.

Handouts downloaded

from eatsmartmove-morenc.com

were also distributed at these events.

Film Screenings and Panel Discussions Sustainable Sandhills is a nonprofit organization dedicated to conserving the natural resources of the eight county region surrounding Ft. Bragg. Through education, demonstration, and collaboration, they are changing the ways people live, work and play. Sustainable Sandhills partnered with the 2020 Vision Committee to host two film screenings and panel discussions– one for “Fresh! The Movie” and one for “Two Angry Moms.” FRESH celebrates the farmers, thinkers and business people across America who are re-inventing our food system. Each has witnessed the rapid transformation of our agriculture into an industrial model, and confronted the consequences: food contamination, environmental pollution, depletion of natural resources, and morbid obesity. Forging healthier, sustainable alternatives, they offer a practical vision for a future of our food and our planet. Two Angry Moms showcases the experiences of two women who were determined to make changes in the foods offered in their local schools. The movie shows not only what is wrong with many school foods, it offers strategies for overcoming roadblocks and getting healthy, good tasting, real food into school cafeterias. The movie explores the roles the federal government, corporate interests, school administration and parents play in feeding our country’s school kids. In Montgomery County, the Two Angry Moms video was followed by a discussion facilitated by Kea Meachem, with Sustainable Sandhills, and featured local experts including a parent, and representatives from Cooperative Extension Service, Montgomery County Schools Child Nutrition Program, Healthy Vessels, Montgomery County Schools Nurse, and the Montgom-ery County Health Department. For more information on the

movies, or on the Sustainable Sandhills Program, contact Kea Meacham at keam@sustainablesandhills.org.

Color Me Healthy The Family and Consumer Science, with the Montgomery County Cooperative Extension Service, provided 27 teachers with the Color Me Healthy training this year. Each teacher received a $65 kit free of charge. One hundred percent said they learned something new and planned to implemented the program with the children with whom they work. Using Color Me Healthy in the classroom increases recognition of fruits and vegetables, willingness to try new foods, and increases physical activity in children. Increased fruit and vegetable consumption and increased physical activity are two behaviors consistent with a healthy weight. Adopting these behaviors early in life is associated with lifelong adoption of healthy eating and physical activity. One teacher commented, “Not only will Color Me healthy help my students, but I am going to implement it at home as well.” Over 258 young children in Montgomery County will benefit from this training. The Cooperative Extension Service has also received grant funding that will allow them to teach a version of the Color Me Healthy program to all kindergarteners at Troy and Green Ridge Elementary schools in the spring of 2011. This nine week program will introduce children to lots of tasty fruits and veggies and fun ways to be active. For more information about Color Me Healthy, please contact Molly Alexi, Director of the Montgomery County Cooperative Extension Service, by calling (910) 576-6011 or emailing

molly_alexi@ncsu.edu.

P A G E 9

Policy and Environmental Changes Regarding Obesity

Food Safety and Nutrition Education In Montgomery County, 30% of children and youth are known to be overweight or obese and 74% do not consume the recommended vegetable servings daily. A food Safety and Nutrition Education 10-week program was conducted at one elementary school by the 4-H Youth Development and Family and Consumer Science Agents. There were 65 students participating who increased their knowledge of healthy snack preparation, proper hand washing techniques, prevention of food-borne illness and how to read food labels. Teachers in all classes reported students reading more food labels and making better choices in choosing lunches and snacks. According to one teacher, the students have become far more conscious of making sure they wash their hands and taking more time with the process. Others observed the students increasing their physical activity. For more information about the program, contact Chrissy

Haynes, 4-H Youth Development Agent, by emailing chrissy_haynes@ncsu.edu.

Sponsored by the Montgomery County Employee Wellness Committee and the Montgomery County Cooperative Extension Service, the Montgomery County Tailgate Market opened on Tuesdays and Fridays in June 2010 and will continue as long as there is interest and participation by vendors and shoppers. The market is open to any vendor in Montgomery County and aims to increase access to fresh produce. Studies have shown that easier access increases the average consumption of fruits and vegetables, which in turn leads to their achievement and maintenance of a healthy weight. Additionally, a farmer’s market opened at Montgomery Community College and is available on Wednesdays from 3:30 until 6:30. For more information on the Montgomery County Tailgate Market, contact Brenda Caudill, Montgomery County Employee Wellness Committee Chair by calling (910) 572-1393 x264 or by emailing her at brenda.caudill@montgomerycountync.com. For more information on the market at Montgomery Community College,

please call Gay Roatch at 910-576-6222 x209 or by emailing her at roatchg@montgomery.edu.

Classroom Celebration Policies. A total of eight elementary school teachers in Montgomery County have passed “Classroom Celebration Policies”. These policies assure that teachers intend to encourage healthy celebrations and parties in their classes during every school year. The policy states that classroom snacks and celebrations should reinforce the importance of healthy choices. By encouraging more nutritious snack choices, in the proper portion sizes, teachers can help improve the health of their students, which in turn, will help them succeed academically. In addition to the food personally offered by teachers, signing these policies shows their intention to encourage parents to provide healthy snacks when they bring food into the classroom. It is important to note that these policies do not ban or forbid any items from being brought in, but simply encourages more healthful choices. By signing these policies, teachers are not becoming “food police” but are simply attesting that they recognize the importance of healthy food choices, and will encourage their presence in their classroom. In addition to the eight teachers who have already signed policies, many other teachers are considering their adoption. The Montgomery County Health Department has worked with all of these teachers to provide them with parent letters (both in English and Spanish) explaining the policy to families, and also giving teachers promotional items to display in their classrooms. If you are interested in passing a similar policy in your class, please contact Rhonda

Peters at the Montgomery County Health Department by emailing rhonda.peters@montgomerycountync.com.

Church Promises to Provide Healthy Foods and Be More Active. In collaboration with the Sparrow Project, Belford Baptist Church passed policy to show their concern about the health of their members. People have become more and more interested in eating better and being more active. Heart disease, cancer, and stroke are largely affected by what people eat and how active they are. Regular physical activity provides for increased quality of life through improved endurance, strength, flexibility, and balance, as well as reduced risk of chronic diseases, injury and perception of stress. Foods such as fruits, vegetables, whole grain breads and pastas, and low fat dairy products are better choices for preventing many diseases. As such, effective June 2010, Belford Baptist Church adopted a policy to include opportunities for physical activity in activities and events sponsored by the church and that events will always include one or more healthier foods items such as fruits and/or vegetables, lowfat milk and dairy products, and foods made from grains.

For more information on the Sparrow Project, contact Alice Stradford by emailing alice.stradford@co.robeson.nc.us.

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Priority Issue: Physical Activity and Recreation Data for Montgomery County is depicted in the map

on the left as a part of a region where participants

responded to the 2009 Behavioral Risk Factor

Surveillance System (BRFSS). According to this data,

less than 50% of adults reported meeting daily physical

activity requirements. Additionally, results from the

2009 Youth Behavioral Risk Factor Surveillance

System indicate that 51.9% of high school students in

our region report not being physically active for a total

of at least 60 minutes on five or more days of the

week. 41.6% of middle school students also reported

not meeting the physical activity guidelines.

their partners across the state

to get and keep at-risk

adolescents ages 9-14 moving

more and sitt ing less.

Montgomery County received

a total of $18,000, with $1100

to be dispersed during the

2010-2011 fiscal year, and the

remaining $16,900 to be

dispersed during the 2011-

2012 year. For the first time,

the Eat Smart, More More NC

community grants are being

awarded for a two year cycle

to study the impact the grants

are having in the communities

that receive them. The Robert

Wood Johnson Foundation

awarded funding in the fall of

2009 to the N.C. Division of

Public Health’s Physical

Activity and Nutrition Branch

to work with East Carolina

University’s Department of

Public Health in evaluating the

program. Montgomery

County will receive funding for

data collection in 2010-2011

a n d f o r p r o g r a m

implementation in 2011-2012.

As part of the data collection

process, in November 2010,

EMS students were asked (with

parental permission) to

complete surveys indicating

their current physical activity

habits. Of those completing

the survey, 69 students were

randomly chosen to wear

accelerometers continuously

for one week. Results from

this data collection will be

available in March of 2011.

This process will be repeated

in the fall of 2011 and 2012.

“East Middle School Students

Eat Smart and Move More” has

been conceptualized to include

a project team that will

oversee all facets of the

intervention, with task forces

specific to construction and

development of the trail and

implementation of the walking

p r o g r a m . F o r m o r e

information on this project,

or if you would like to help,

please contact Rhonda Peters

at the Montgomery County

Health Department by emailing

rhonda.peters@montgomery

countync.com.

In May 2010, Montgomery

County Health Department

collaborated with Montgomery

County Schools, FIrstHealth

2020 Vision Committee, Town

of Biscoe, FirstHealth School

Based Health Centers, and

others to submit a grant

proposal to the Eat Smart,

Move More North Carolina

community grant program.

With full support from Dr.

D o n n a P e t e r s , M C S

Superintendent (at that time),

and Joan Frye, principal at East

Middle School, the “East

Middle School Students Eat

Smart and Move More”

proposal requested funds to

construct a 1/2 mile walking

trail on school campus and

implement an after-school

walking club.

In June 2010, the Montgomery

County Health Department

received notification that the

application was selected to be

awarded funding. The Eat

Smart, Move More NC

Community Grants program

awarded a total of $300,000 to

twenty health departments and

Physical activity and recreation was chosen as a community health priority

for the years 2008-2012 in Montgomery County. The community adopted an

action plan to address this issue, and included marketing activities,

implementation of the Sports, Play and Active

Recreation for Kids (SPARK) program, and implementation of the

Healthy Eating Active Play (HEAP) program,. The

SPARK program is currently functioning in the school system, and HEAP is scheduled to resume in 2011. Marketing activities

have been conducted throughout the community

during the year. The majority of the work done in

Montgomery County in 2010 to address physical

activity is outside the realm of planned initiatives

included in the plan of action adopted by the

community for 2008-2012 but has strong potential to increase physical activity

opportunities in our county.

Grant Awarded- “East Middle School Students Eat Smart and Move More”

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In the spring of 2010, members of

the FirstHealth 2020 Vision Task

Force partnered with West Middle

School to offer “Destination E:

Eating Right, Exercising Often,

Enjoying School Success”. The

twelve week after school program

met three times each week and

provided students the opportunity

to receive tutoring and academic

help to prepare them for end of

grade testing, as well as to engage

in physical activity and receive

nutritional education. Christina

Turbeville, Nutrition Educator with

the School Health Centers

facilitated the project which

averaged 80 participants, and

included as many as 120 students

on many days. After school,

students met in the cafeteria and

engaged in a ten minute nutrition

lesson, followed by thirty minutes

of a structured physical activity.

Although original plans for the

program included high school

students mentoring the middle

school students and leading in the

activities, funding for transportation

was cut halfway through the

program and the high school

students were no longer able to

participate. Nevertheless, program

participants remained active during

the time allotted and then enjoyed

a healthy snack provided through

the Child Nutrition Program with

the Montgomery County Schools.

As with most pilot projects, there

were many lessons learned along

the way, but overall the program

was considered a success by

project facilitators, teachers, and

school administration. For more

information on the program,

contact Christina Turbeville,

Nutrition Educator, by emailing

cturbeville@firsthealth.org or

Rocanne Leopper, 2020 Vision

Committee Chair, by emailing

rleopper@firsthealth.org.

to race in the half marathon at

Myrtle Beach in February of

2011. Under Tammy’s

guidance, Mechelle Smith leads

the MoCo in Motion Mini

Milers program, which is a

running team open to children

ages 8-15. This group meets

once per week for group

training. Tammy hopes to

establish a walking team in

Montgomery County in the

near future. There are already

more than fifty names on the

list for this team and six walking

coaches have been lined up to

As the owner and operator of

GetFit StayFit, Tammy Owens

specializes in outdoor boot

camp training. She teaches a 10

week class in the spring and fall

of every year. On March 13,

2010, she established the MoCo

in Motion Running Team which

currently has between 20 and

30 members. They team has

participated in several 5K races

in Stanly County, Davidson

County and Moore County.

The team plans to run in an

upcoming 5K/10K in Southern

Pines in December and hopes

assist with the project. This

team will start out completing a

12 week walking program that

will enable beginners to get

moving. All teams are open to

men and women, and currently

there is no charge for the Mini

Milers or the walking and

running teams. For more infor-

mation, please contact Tammy

Owens by emailing getfitstayfit-

bootcamp@yahoo.com and

v i s i t h e r w e b s i t e a t

www.GetFitStayFitbc.com.

Healthy Vessels Community Garden Started On Thursday, May 27th, Covington Missionary Baptist Church, Body of Christ United and Youth Empowered Solutions (YES!) worked together to plan the Healthy Vessels community garden. The garden was planted at Covington Missionary Baptist Church, right outside of downtown Troy, NC. The purpose of a community garden is to create unity, increase physical fitness, provide access to fresh vegetables, provide resources for community members to grow their own gardens, and to empower youth to be a part of a community change. The first two garden beds were constructed with the help of Gordon Knowles, master gardener, and with funding support from the Robert Wood Johnson Foundation. The gardens were planted and overseen by the youth of Covington Missionary Baptist Church. The gardens have been very fruitful this summer producing tomatoes, potatoes, cucumbers, onions, bell peppers, green beans and watermelons. A portion of all vegetables has been given to local people in need and to help provide more access to fresh food options. Members of the 2020 Vision Committee have fully endorsed this project and similar projects. “We are proud of the work that’s been done, and would love to see more community gardens throughout the county”, stated Brenda Caudill, Health Educator with the Montgomery County Health Department and member of the 2020 group. For information about the

Healthy Vessels community garden, please contact Cindy Taylor at (910) 571-8793.

GetFit Stay Fit. (MoCo in Motion and MoCo in Motion Mini Milers)

New Physical Activity

Initiatives Include:

• East Middle School Walking Trail

• Destination E

• Community Gardens

• GetFit StayFit

• Healthy Kids, Healthy Communities

WANT TO BECOME INVOLVED?WANT TO BECOME INVOLVED?WANT TO BECOME INVOLVED? See contact names and numbers included in this publication, or call the

Health Education Staff at the Montgomery County Health Department for more information. (910) 572-1393 x264.

Priority: Physical Activity (continued) Healthy Kids Healthy Communities Project. In December 2009, the Robert Wood Johnson Foundation awarded FirstHealth of the Carolinas a grant to fund the Healthy Kids Healthy Communities project. FirstHealth received one of only fifty grants the Foundation awarded across the nation. Program sites in Montgomery County include Candor and Mt. Gilead and were chosen based on the high free and reduced lunch rates in these areas. The project aims to use the strengths and assets of communities in Moore and Montgomery counties to create policies and changes in the built environment that prioritize the health of our communities and result in the reduction of childhood obesity region-wide. Project members have been working this first year to form the coalition and identify community champions. Goals for the Healthy Kids Healthy Communities partnership include making policy and environmental changes; offering healthy food options at local corner stores in Candor; working with local farmer’s markets, food co-op’s, and community supported agriculture (CSA)s to accept EBT payments; working with local farmer’s markets, co-ops, and CSA’s to accept WIC food package vouchers and WIC farmer’s market coupons; providing children and families with a safe environment to be physically active through the creation of “Parkway Sundays” events in Mt. Gilead and Candor; and developing a plan for connecting existing sidewalks and greenway trails from neighborhoods with high percentages of children to child centered locations (such as schools, parks, after-school programs) to encourage bicycle use and walkability. In November 2010, a “Play in the Park” event was held at Fitzgerald Park in Candor. The afternoon included a bike rodeo, zumba demonstration, warm-up and stretch, one mile fun run/walk, bike ride, cool-down/stretch, hula hoop contest, jump rope contest and dancing. In Mt. Gilead, the HKHC project has hosted a Parkway Sunday event, has placed a farmer in the parking lot of Food King, and is working on adopting a healthy foods policy for town sponsored events and concessions. For more information about the Healthy Kids Healthy Communities initiative, please contact Cindy Laton, Project Coordinator by calling (910) 255-3645 or emailing

claton@firsthealth.org.

Dissemination Plan. Copies of this publication will be disseminated to key stakeholders and community partners, including members of the 2020 Vision Committee, the Montgomery County Board of Commissioners, the Montgomery County Board of Health, and other contributors. The report will also be available to the general population for viewing at public libraries throughout the county and on the Montgomery County website: www.montgomerycountync.com. Press releases about this data will be distributed to local newspapers, and copies will be available for no charge, upon request by contacting Rhonda Peters at the Montgomery County Health Department- (910) 572-1393x265 or by emailing rhondapeters@montgomerycountync.com.

Members of the FirstHealth 2020 Vision

Committee include Representatives

from the following agencies and organizations:

• Community Representatives

• Faith-Based Representatives

• FirstHealth of the Carolinas

• FirstHealth School Based Health Centers

• Montgomery County Cooperative Extension Service

• Montgomery County Health Department

• Montgomery County Partnership for Children

• Montgomery County Schools

• Town of Mt. Gilead • Troy-Montgomery

Senior Center

New Economic Initiative:

Shop Montgomery 1st Campaign The Montgomery County Chamber of Commerce/ Montgomery Economic Development Corporation has launced a new campaign “Shop Montgomery 1st”. The point of this campaign is to encourage people to think local first. By shopping locally, people help rebuild the community– both by supporting neighbors and contributing to the local tax base. Shopping locally helps keep dollars in the local economy. Dollars spent in the locally-owned businesses have three times the impact in the community as dollars spent at national chains. According to the American Independent Business Alliance, $45 of every $100 spent locally stays in the community. If sales increased an additional 10 percent, that would generate $500,000 for the county. The tax money goes toward improving libraries, schools, roads, fire services, parks, health care, and much more. Shopping locally enhances community well-being by sustaining communities, linking neighbors, and by contributing more to local causes. Shopping locally also creates more local jobs and increases the likelihood of important decisions being made by people who live in the community and feel the impact of those decisions. Shopping locally helps attract new businesses, fund local government, and give greater support to non-profit organizations. The Chamber of Commerce has added a “Montgomery County Yellow Pages” listing to their webpage so consumers can become aware of what is available in the county and know where to shop for those items. The yellow pages can be accessed at www.montgomery-county.com. For more information on this initiative, please contact Judy Stevens, Executive Director of the Montgomery County Chamber of Commerce by calling

910-572-2575 or by emailing judy@montgomery-county.com.

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